U.S. Hospitals: Using Facebook, YouTube and Twitter

Great post listing the U.S. Hospitals using social networking tools like YouTube, Facebook and Twitter. Check out the complete list of 150 hospitals and a related FAQ about the Hospital Social Networking List at Found In Cache: Notes from a Hospital Web Manager authored by Ed Bennett.

Thanks to @schwen for pointing out the list.

Medical Uses of Twitter: Twitter Consult

Two case studies pointing out additional medical uses for Twitter from Jennifer Texada at How to Go Web 2.0.

Her post, Health 2.0 Makes it to Twitter, discusses two separate cases. The first involved the use of Twitter by medical professionals seeking real time advice with a diagnosis. Call it a "Twitter Consult." The second involved a researcher looking for exercise study participants who were endometrial cancer survivors.

West Virginia: The Roadmap to Health Project

Last week Kenneth E. Thorpe, PhD of Emory University released the Roadmap to Health Project report to the West Virginia Legislature's Select Committee D on Health. The Roadmap to Health Project is an initiative by Select Committee D. The full report is titled, "West Virginia Health Care Reform - Roadmap to Health Project: Final Recocommendations to Select Committee D."

Lessons For PowerPoint Users

Yesterday I did a presentation for the West Virginia Healthcare Financial Management Association on Social Media, Consumer Driven Health Care, Health 2.0 and the Legal Implications. Today I see friend and creative guru, Jeff James' post on Begin With PowerPoint in Mind which highlights how NOT to use PowerPoint and links to a Top 10 Best Presentations Ever.

The how NOT to use PowerPoint is a must see for anyone who uses PowerPoint. I have yet to watch the Top 10 but plan to go back and check them out to see how I can improve my skills. Thought others might be interested in checking out this top 10 list.

American Well: e-House Calls by the Hawaiian Doctor

Today Hawaii Medical Service Association along with American Well roll out American Well's technology that redesigns the house call -- call it "e-House Call." More about the joint effort and how to log in can be found at HMSA's Online Care For Consumers.

American Well's technology allows live, face-to-face consultations between physicians and patients. The technology matches up the patient with the physician. Hawaii hope that the project will provide convenient, affordable and better access to health care in a state (not unlike West Virginia) that has remote areas/islands.

I plan to invite American Well to West Virginia to see whether we might roll out a similar effort in conjunction with the West Virginia Health Information Network or as a part of the innovation community under the Medicaid Transformation Grant program that I am working on through the West Virginia Health Improvement Institute.

More background information in the AP News article, "The Hawaii doctor is in - online." Also, David Harlow over at HealthBlawg recently examined whether American Well might be the disruptive innovation to unseat retail based health clinics.

Tip to @jenmccabegorman.

WVHFMA: Consumer Driven Health Care

Tomorrow I will be speaking on consumer driven health care at the West Virginia Chapter Healthcare Financial Management Association's Winter Education Conference in Charleston, West Virginia.

I thought I would post my slides for the presentation titled, Consumer Driven Health Care: The Impact of Social Media and Health 2.0. The presentation is an introduction to the concepts of social media, health 2.0, consumer driven health care and some of the legal implications.

This past week I ask my social media network on Facebook and Twitter to help develop a list of words and phrases that represent Consumer Driven Health Care. The results are included in the presentation.

WVHFMA CDHC And Health 2.0 (1 15 09)

View SlideShare presentation or Upload your own. (tags: driven consumer)

My Family Health Portrait: A Family PHR

The Surgeon General has launched a new online tool allowing a user to create an electronic family health tree to track your family health history. The site is called "My Family Health Portrait." The Surgeon General press release.

The tool draws on the value of creating a family health genealogy and marries it with the concepts of PHRs. The tool states, "using My Family Health Portrait you can:

• Enter your family health history.
• Create drawings of your family health history to share with family or health care worker.
• Use the health history of your family to create your own.

The new site lets users create and download their health information into their own computers and e-mail a tree-in-progress to family members to fill in missing health history information. The site also allows a user to "reindex" the tree to include any person in the tree as the center of information. For example I can create a health tree for my family but by sending it to one of my sisters or cousins who adds to the health information tree that person can then reindex the site to look at their health history and potential health risks.

According to the details on the website the tool will be interoperable and EHR-ready (i.e., developed using HL7 Family History Model, LOINC, SNOMED-CT and HL7 Vocabulary) . Information included in the My Family Health Portrait can then be transferred and embedded in EHRs or PHRs. The details on the website indicate that the tool is open source, free and can by "adopted" by other organizations.

Coinciding with the release of My Family Health Portrait, the Office for Civil Rights (OCR) has published new HIPAA Privacy Rule FAQs related to family medical history. The new FAQs support the roll out of the Surgeon General's family health history portal.

The FAQs address the following questions:

1. Does the HIPAA Privacy Rule limit an individual’s ability to gather and share family medical history information?

2. Does the HIPAA Privacy Rule limit what a doctor can do with a family medical history?

3. Under the HIPAA Privacy Rule, may a health care provider disclose protected health information about an individual to another provider, when such information is requested for the treatment of a family member of the individual?

More from the Washington Post. Tip from iHealthBeat.

Wordle: Health Care Law Blog

I noticed recent tweets about Wordle, an ultra cool "word count" generator. Here is an example pulled from the text of my Health Care Law Blog. Give it a try for your blog, tweets or next presentation.

Lifeline Television Program: Health Information Exchange and Health 2.0

Last month I had the opportunity to tape a television segment on Health Information Exchange and Health 2.0 for Lifeline, a weekly 30 minute public television program focusing on health and Medicare information for West Virginians. The segment started running this week and should run through the month of January. 

The show is produced by West Virginia Medical Institute to help educate West Virginians on a variety of health, Medicare and healthy living topics. Marc McCombs, WVMI's Director of Corporate Communications hosts the weekly shows. Many of Lifeline's topics are also covered in WVMI's companion print newsletter, also called Lifeline.

Lifeline airs on the West Virginia Library Television Network in over 200,000 households throughout the state. Lifeline airs every week in the Charleston area on Suddenlink Channel 17 at the following times:

• 11:00 AM Tuesday
• 5:00 PM Tuesday
• 11:00 PM Tuesday
• 5:00 AM Wednesday
• 2:00 PM Saturday 

You can find the channels for other cable systems airing the program around West Virginia by going to the Lifeline webpage. Also, the Lifeline page lists some of the archive shows. Below is a teaser clip from the show.

10 Things Small Business Owner Should Do In 2009

A post on the Top 10 Things Every Small Business Owner Should Do in 2009 by Guy Kawasaki came across my screen this morning via @paulhelmick and caught my eye.

Great advice for any business person to consider and "do" in 2009. We can all do better at understanding how our customers view us and improving on the service or product we offer them.

ESPN World's Strongest Man Competition 2008 - Charleston WV

Everyone be sure sure to tune in to the ESPN World's Strongest Man Competition 2008 starting to air on ESPN2 on December 25 (7pm-1am) and ESPN on December 28 (1pm-7pm).

Charleston, West Virginia played host to the 2008 competition. I look forward to ESPN showing off the beauty and positive aspects of Charleston and West Virginia. Also, the hometown of the 2006 World's Strongest Man, Phil Pfister.

UPDATE: Today's Charleston Daily Mail  issues official announcement of the airing of 2008 World's Strongest Man Competition on ESPN.

ONCHIT Issues Nationwide Privacy and Security Framework for Electronic Exchange of Health Information

Today the Office of the National Coordinator for Health Information Technology (ONCHIT) issued The Nationwide Privacy and Security Framework for Electronic Exchange of Individually Identifiable Health Information. The summary states that the framework creates a set of consistent principles to:

". . .address the privacy and security challenges related to electronic health information exchange through a network for all persons, regardless of the legal framework that may apply to a particular organization. The goal of this effort is to establish a policy framework for electronic health information exchange that can help guide the Nation's adoption of health information technologies and help improve the availability of health information and health care quality. The principles have been designed to establish the roles of individuals and the responsibilities of those who hold and exchange electronic individually identifiable health information through a network."

Along with the Nationwide Privacy and Security Framework the Department of Health and Human Services (HHS) has issued The Health IT Privacy and Security Toolkit. The Toolkit includes new HIPAA Privacy Rule guidance documents developed by the ONCHIT and the Office for Civil Rights (OCR) to help facilitate the electronic exchange of health information.

Of particular interest to many interested in PHRs will be the OCR's guidance on Personal Health Records and the HIPAA Privacy Rule and the draft Draft Model Personal Health Record (PHR) Privacy Notice & Facts-At-A-Glance (the "Leavitt Label").

The Toolkit provides information and guidance focused around these key areas:

• Individual Access Principle - Individuals should be provided with a simple and timely means to access and obtain their individually identifiable health information in a readable form and format.
• Correction Principle - Individuals should be provided with a timely means to dispute the accuracy or integrity of their individually identifiable health information, and to have erroneous information corrected or to have a dispute documented if their requests are denied.
• Openness and Transparency Principle - There should be openness and transparency about policies, procedures, and technologies that directly affect individuals and/or their individually identifiable health information.
• Individual Choice Principle - Individuals should be provided a reasonable opportunity and capability to make informed decisions about the collection, use, and disclosure of their individually identifiable health information.
• Collection, Use, and Disclosure Limitation Principle - Individually identifiable health information should be collected, used, and/or disclosed only to the extent necessary to accomplish a specified purpose(s) and never to discriminate inappropriately.
• Data Quality and Integrity Principle - Persons and entities should take reasonable steps to ensure that individually identifiable health information is complete, accurate, and up-to-date to the extent necessary for the person's or entity's intended purposes and has not been altered or destroyed in an unauthorized manner.
• Safeguards Principle - Individually identifiable health information should be protected with reasonable administrative, technical, and physical safeguards to ensure its confidentiality, integrity, and availability and to prevent unauthorized or inappropriate access, use, or disclosure.
• Accountability Principle - These principles should be implemented, and adherence assured, through appropriate monitoring and other means and methods should be in place to report and mitigate non-adherence and breaches.

I have only made an initial pass though the information and guidance documents. There is a lot to read and digest over the holidays. Please post in the comments your thoughts on the new federal principles and guidelines.

Does the Certificate of Need Law Benefit West Virginia?

Joe Letnaunchyn, CEO of the West Virginia Hospital Association, responds to the continuing discussion on the pros and cons of certificate of need regulatory oversight in West Virginia. The commentary, Certificate of Need Program Benefits West Virginia, appears in the most recent edition of the State Journal.

Mr. Letnaunchyn responds to the commentary by Dashle Gunn Kelley, dated October 30 2008, State Doesn't Need Certificates of Need, asserting that West Virginia "doesn't need certificates of need" to deliver health care. Mr. Kelley is a doctoral student in economics at West Virginia University and is an associate fellow for the Public Policy Foundation of West Virginia.

Throughout the year the Select Committee D - Health (Subcommittee Certificate of Need) - Interim has been looking at the issues involving certificate of need in West Virginia. Highlights of the Interim Meetings can be found here. I suspect that the discussion and debate will continue at the upcoming West Virginia Legislative session.

UPDATE (12/19/08): The latest edition of the State Journal contains a follow up commentary on West Virginia's certificate of need program. The commentary, Who Really Benefits from the Certificate of Need Program? was written by Russell S. Sobel, Ph.D., is professor of economics, holder of the James Clark Coffman Distinguished Chair at West Virginia University and editor of the book "Unleashing Capitalism: Why Prosperity Stops at the West Virginia Border and How to Fix It."

Reengineering Health Information Technology to Wire The Medical Home

Over at The Health Care Blog Dr. Kibbee issues Part 2 of his Confessions of a Physician EMR Champion, subtitled "A Conversation with American Physicians About How to Save Medicine in the Age of Information." The Part 2 post, Empowering Health IT for the Connected Medical Home, is a must read for all interested in the world of changing world of health/technology.

Dr. Kibbe lays out 5 areas that health IT should focus on to be empowering and disruptive to the current models:

1. electronic data and information collection and access
2. communications among providers and patients
3. clinical decision support
4. population quality, performance, and cost reporting
5. consumer/patient education and self-management

He highlights the importance of stepping back and looking at the current EMR model (a bit of thinking outside the box):

There is nothing transformational or disruptive about EMRs because they have been designed to meet the functions and features of a status quo business model -- not the collaborative and participatory capabilities required of the business models of the future health system.

In this next installment of the conversation, I’d like to suggest some specific capabilities that health IT ought to empower doctors and health care teams to perform on behalf of, and in collaboration with, their patients.

I’m suggesting that we go back to the drawing board and design health IT that is truly a good fit for doctors and patients in a system that rewards quality, safety, and efficiency of care while working to keep people healthy, instead of simply adding up the charges when they’re sick.

I'm involved on a number of fronts looking at health information models for West Virginia that will improve the delivery of care and reduce the costs. Dr. Kibbee's comments and thoughts are valuable for others looking at these same issues.

Tip to Ted Eytan on the post.

Engage With Grace

Last month I had the opportunity to watch Alexandra Drane announce Engage With Grace: The One Slide Project at the Health 2.0 Conference in San Francisco. The idea behind the project is to get people to share just ONE slide that helps them and their loved ones talk about having a purposeful end-of-life experience.

Alexandra's talk personally touched me because my family went through a similar experience 30 years ago when I was 12 years old. My mother died at home with cancer in 1978. She had the opportunity to die at home surrounded by her 5 children because both my dad and uncle were her doctors. In the past and today, not all families are given this important choice. The memories I have of my mother's final days 30 years ago are still important to me today.

Last week, Matthew Holt who blogs at The Health Care Blog and Paul Levy, CEO of Beth Israel Deaconess Medical Center in Boston who blogs at Running A Hospital, spread the word to bloggers about a viral campaign (call it a blog rally) to raise awareness by encouraging families to discuss end of life care issues while gathering for the Thanksgiving holiday weekend.

For West Virginia readers who want to learn more about end of life care I recommend checking out the resources provided by the West Virginia Center for End of Life Care. There is also valuable information for health care professionals. Here individuals can find forms for the standard West Virginia Living Will and Medical Power of Attorney. The site also includes information, FAQs, list of West Virginia palliative/hospice providers and other resources.


Engage with Grace from Health 2.0 on Vimeo.

Below is a message being posted today and throughout the Thanksgiving holiday weekend at blogs around the country and the world:

We make choices throughout our lives - where we want to live, what types of activities will fill our days, with whom we spend our time. These choices are often a balance between our desires and our means, but at the end of the day, they are decisions made with intent. But when it comes to how we want to be treated at the end our lives, often we don't express our intent or tell our loved ones about it.This has real consequences.

73% of Americans would prefer to die at home, but up to 50% die in hospital. More than 80% of Californians say their loved ones “know exactly” or have a “good idea” of what their wishes would be if they were in a persistent coma, but only 50% say they've talked to them about their preferences. But our end of life experiences are about a lot more than statistics. They’re about all of us. So the first thing we need to do is start talking.

Engage With Grace: The One Slide Project was designed with one simple goal: to help get the conversation about end of life experience started. The idea is simple: Create a tool to help get people talking. One Slide, with just five questions on it. Five questions designed to help get us talking with each other, with our loved ones, about our preferences. And we’re asking people to share this One Slide – wherever and whenever they can…at a presentation, at dinner, at their book club. Just One Slide, just five questions. Lets start a global discussion that, until now, most of us haven’t had.

Here is what we are asking you: Download The One Slide and share it at any opportunity – with colleagues, family, friends. Think of the slide as currency and donate just two minutes whenever you can. Commit to being able to answer these five questions about end of life experience for yourself, and for your loved ones. Then commit to helping others do the same. Get this conversation started. Let's start a viral movement driven by the change we as individuals can effect...and the incredibly positive impact we could have collectively. Help ensure that all of us - and the people we care for - can end our lives in the same purposeful way we live them. Just One Slide, just one goal. Think of the enormous difference we can make together.

(To learn more please go to www.engagewithgrace.org. This post was written by Alexandra Drane and the Engage With Grace team)

UPDATE: Paul Levy provides a post-rally update thanking those engaging gracefully. There were well over 95 bloggers over the Thanksgiving holiday weekend helping to spread the word.

Blawg Review # 186: Blawgers Are All-A-Twitter

Res Ipsa Blog brings you this week's edition of Blawg Review -- Blawg Review #186. This edition begins with a summary of the raging Twitter Wars and includes a link to a post I did last week discussing some of the legal implications of live tweeting in health care.

Check out this week's edition for the latest law news from around the blogosphere.

Medicare PHR Pilot Project

HealthcareIT News reports on the announcement of a Medicare personal health record (PHR) pilot project that will be made available to Medicare beneficiaries in Arizona and Utah.

The four PHR companies selected out of almost 40 who applied to participate in the pilot are: Google Health, HealthTrio, NoMoreClipboard.com and PassportMD.

The Arizona Republic has more on the pilot project. More background information on CMS's PHR projects.

Tip to iHeathBeat on the article.

UPDATE: Today's iHealthBeat indicates that interoperable PHRs could result in$21B savings per study conducted by Center for Information Technology Leadership. Read the press release and full Value of Personal Health Records report.

The Implications for Live Tweeting Surgery

Yesterday Robert Hendrick, health care disruptor (I mean that in a positive way) and co-founder of change:healthcare, live tweeted his laser ablation surgery at the Surgical Clinic in Nashville. He also tweeted the first installment of his surgery to remove his varicose veins -- Live from the Operating Room.

Robert and his counterpart, Christopher Parks, are all about transparency in health care, especially as it relates to payment issues. This serves as just one more example of their efforts to engage health consumers and create transparency in health care.

Robert's live tweeting during surgery struck me as an interesting application of Twitter and other mobile social networking application. Here are just a few thoughts:

• A way to keep friends and family updated on your condition, surgery, etc.
• Useful for others who might be contemplating a particular procedure or surgery to get a real time look at what might be involved. I know someone who is contemplating undergoing the same procedure and plan to share Robert's posts with them.
• As more and more patients and providers start to document information via social networking avenues - what might this mean during future litigation and discovery? Certainly seeking tweets, historical Facebook updates, etc. might be valuable in either pursuing or defending litigation. What are the rules for lawyers in pursuing such evidence? What might this mean for the companies providing such services as they see more and more subpoenas for information?
  

For a real time look at surgery tweets check out Twitter Search for the term -- surgery. Interesting stuff. I welcome others thoughts on the topic.

Thanks Robert for making my day for awarding me "best tweet of the procedure." Follow Robert on Twitter at @Robert_Hendrick.

UPDATE (1/18/09): More discussion on live tweeting surgery. This time it is from the provider side and not just the patient tweeting away their surgery. Henry Ford Health System live tweeted a surgical procedure in Detroit to a group of medical professionals at a conference in Las Vegas.

Shel Israel at Global Neighborhood has a great summary/interview with background on the event that will be part of his upcoming book, Twitterville. Bertalan Mesko has provides coverage about the Live Tweeting Surgery at at ScienceRoll. To find all the tweets about the surgery search via Twitter Search for the tag: #twOR.


After seeing the post by Shel I reached out to him and told him this wasn't the first live tweeted surgery. However, it was the first tweeted "from the provider side" -- @HenryFordNews.@Robert_Hendrick still gets the 1st award from the patient side.

UPDATE (1/29/09): Noticed in my Twitter stream today that Rick Sanchez of CNN is live tweeting his knee/meniscus surgery. Another live tweeting patient. In this case, high profile reporter from CNN. Follow Mr. Sanchez's twitter stream at @ricksanchezcnn.

UPDATE (2/17/09): Elizabeth Cohen of CNN (@elizcohenCNN)covers the live tweeting of surgical procedures by hospitals in the article, Surgeons send 'tweets' from operating room. Included with the article is a video detailing the live twittering at Henry Ford Health Systems. You can also follow the tweet stream of the surgery tagged via Twitter as: #hfhor.

UPDATE (5/26/09): mobilehealthnews provides a historic timeline of the most notable examples of live tweeting surgery in a post, Twitter surgery timeline: 8 months of OR Tweets.

Why Is Healthcare So Expensive?

A simplified view of Why is Healthcare So Expensive? from Stay Smart Stay Healthy. Stay Smart Stay Healthy is a Humana new-media venture designed to deliver guidance, and to support awareness and understanding of the healthcare industry.

Our goal is simple: to educate consumers on the healthcare system by removing the usual complexities and replacing them with an informative and engaging series of videos.

Check out their other videos on health care.



Tip from KevinMD.

Predicting Flu Season With Google Flu Trends

Google Flu Trends uses search terms as an indicator of flu activity by state.

According to Google.org Flu Trends the aggregated search data can estimate flu activity in a state up to two weeks faster than traditional systems. The chart comparison with CDC data is impressive at showing the consistency between tracking search terms vs. using influenza surveillance data. Read about how it works and the FAQs. More background from the NYT in Google Uses Web Searches to Track Flu's Spread. 

What about privacy concerns? Has Google stepped beyond the boundary of the "trust question" by providing aggregated search information to the CDC? It might depend upon the level of data that is being release to the CDC. Already anyone using Google Trends can get a certain level of aggregated information on a particular topic - for example "Flu".

Privacy is one thing but expectation is another. My experience in dealing with clients on privacy breach matters has lead me to believe that it is often not about whether something should or should not be private -- but rather it is a question of expectation by the person who trusted information with another party. Did that party do something with the information that was unexpected or not agreed to by the parties.

The discussion on privacy has started . . .

• Google To Track Flu Searches and Report Them to Feds? at Volokh Conspiracy
• Sick Surveillance: Google Reports Flu Searches, Locations to Feds at Drudge
• Google Flu Trends: A Glimpse into the future of Google Health at ReadWriteWeb
• Sick? Google Shares Health Searches with Government at CNET Technically Incorrect
• Google Introduces Flu Trends; Gets Red-Font Treatment on Drudge at U.S. Web

Follow the current discussion using the search term: ("google flu trends" privacy) and related search results from Google Blogs.

UPDATE: Interesting follow up thoughts by Mark Hawker and the potential use of Facebook Lexicon as a similar approach to tracking flu and other health conditions.Wasn't aware of Facebook Lexicon feature - interesting tool.